Department of Neurology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
Intern Med J. 2009 Nov;39(11):752-6. doi: 10.1111/j.1445-5994.2008.01878.x.
Atrial fibrillation (AF) is an important predisposing factor for ischaemic stroke. There is evidence to suggest that even in appropriate candidates warfarin therapy is underutilized. We assessed the prevalence of AF in an Australian stroke unit to determine the degree of undertreatment at presentation.
A retrospective analysis of all patients admitted to our Stroke Unit between October 2004 and September 2006 was carried out. All patients with a diagnosis of AF, either new or old, were then selected from this group to determine the overall prevalence and anticoagulation status. Data regarding prior stroke, stroke severity and discharge anticoagulation status were also determined.
Data from a total of 500 patients were analysed. Our results showed that AF-related strokes accounted for a large proportion (28%) of all admissions and were associated with a larger neurological deficit. Most patients (68%) with a prior diagnosis of AF without having obvious contraindications were either not anticoagulated or under-anticoagulated when presenting with an ischaemic stroke or transient ischaemic attack.
Our results stress the importance of initiating and maintaining anticoagulation in patients with AF and without obvious contraindications to minimize the risk of subsequent stroke.
心房颤动（AF）是缺血性卒中的一个重要诱发因素。有证据表明，即使在合适的患者中，华法林治疗的应用也不足。我们评估了澳大利亚卒中单元中 AF 的患病率，以确定在就诊时治疗不足的程度。
对 2004 年 10 月至 2006 年 9 月期间收入我们卒中单元的所有患者进行回顾性分析。从该组中选择所有新诊断或旧诊断为 AF 的患者，以确定总体患病率和抗凝状态。还确定了既往卒中、卒中严重程度和出院抗凝状态的数据。
对总共 500 例患者的数据进行了分析。结果表明，与 AF 相关的卒中占所有入院患者的很大比例（28%），且与更大的神经功能缺损相关。大多数（68%）既往诊断为 AF 且无明显禁忌证的患者，在发生缺血性卒中和短暂性脑缺血发作时，要么未抗凝，要么抗凝不足。
我们的结果强调了在无明显抗凝禁忌证的 AF 患者中启动和维持抗凝治疗以降低随后卒中风险的重要性。
